An interventional study of C-MAC videolayngoscopy technique and Laryngoscopy technique in Intubated Patients and Percutaneous Tracheostomy, sponsored by Hospital Clinico Universitario de Santiago. Recruiting at 2 sites in Spain. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2025-09-15.
Sponsored by Hospital Clinico Universitario de Santiago · Not applicable, Interventional, and Treatment
When preparing an ICU patient for percutaneous dilational tracheostomy, correct positioning of the endotracheal tube is important. During the procedure, it is possible to puncture the cuff. Tracheal tube cuff puncture can lead to failure of ventilation, loss of positive end-expiratory pressure, and possible aspiration of gastric contents blood or secretions. To minimize the risk, in our ICU, we withdraw the endotracheal tube under direct laryngoscopic vision until the cuff is visible at the vocal cords. This maneuver would also facilitate insertion of the Seldinger needle and insertion of the tracheostomy tube below the endotracheal tube. However, this maneuver to remove the endotracheal tube under direct laryngoscopy can sometimes be difficult. ICU patients present frecuently difficult laryngoscopic vision due to airway edema or secretions. In ICU, the videolaryngopy has been shown to be superior to direct laryngoscopy in visualization the upper airway, allowing better laryngoscopic vision.
The investigators aim to compare C-MAC videolaryngoscopy versus conventional direct laryngoscopy for positioning the tracheal tube to facilitate insertion of the Seldinger needle and the tracheostomy tube below the endotracheal tube during percutaneous tracheostomy.
Hospital Clinico Universitario de Santiago is the lead sponsor of 33 studies on the registry; 11 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Endotracheal tube will be removed before percutaneous tracheostomy using a traditional direct laryngoscopy technique.
Device: Laryngoscopy technique
Endotracheal tube will be removed before percutaneous tracheostomy using a C-MAC videolaryngoscope technique.
Device: C-MAC videolayngoscopy technique
Endotracheal tube will be removed before percutaneous tracheostomy using a C-MAC videolaryngoscopy.
Endotracheal tube will be removed before percutaneous tracheostomy using a laryngoscopy
Introduction of the Seldinger needle below the endotracheal tube
Percentage of patients in whom the introduction of the Seldinger needle is below the tip of the endotracheal tube
Time frame: during the procedure
Puncture of the cuff of the endotracheal tube with the Seldinger needle
Percentage of patients suffering puncture the cuff of the endotracheal tube with the Seldinger needle
Time frame: during the procedure
patients who need to remove the endotracheal tube to introduce the percutaneous tracheostomy cannula
Percentage of patients who need to remove the endotracheal tube to introduce the percutaneous tracheostomy cannula
Time frame: during the procedure
Laryngoscopy vision using de Modified Cormack-Lehane grade of glottic view
Differences in laryngoscopy vision using de modified Cormack-Lehane grade of glottic view Modified Cormack-Lehane grade of glottic view: I: full view of the glottis (better outcome) IIa: partial view of the glottis IIb: arytenoid or posterior part of the vocal cords just visible III: only epiglottis visible IV: neither glottis nor epiglottis visible (worse outcome)
Time frame: during the procedure
Difficulty of removing the endotracheal tube
Differences in the difficulty of removing the endotracheal tube due to poor visualization, secretions.... Operator-assessed subjective difficulty of removing the endotracheal tube: No difficulty, mild difficulty, moderate difficulty, severe difficulty.
Time frame: during the procedure
Difficulty of performing percutaneous tracheotomy
Differences in the difficulty of performing percutaneous tracheotomy Operator-assessed subjective difficulty of performing percutaneous tracheotomy: No difficulty, mild difficulty, moderate difficulty, severe difficulty.
Time frame: during the procedure
Complications
Percentage of complications
Time frame: during the ICU stay
Plan to share: No
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Hospital Clinico Universitario de Santiago